JMIR Publications

ABSTRACT

Background:

Electronic health record (EHR) patient portals provide a means by which patients can access their health information, including diagnostic test results. Little is known about portal usage by emergency department (ED) patients.

Objective:

Patient portal utilization by ED patients at an academic medical center was assessed by account activation rates along with rates of access of diagnostic test results (laboratory results and radiology reports), analyzing the impact of age, gender, and self-reported patient race.

Methods:

This institutional review board-approved retrospective study was performed at a 60,000 visit per year university-based ED. We utilized EHR data reporting tools to examine EHR portal activation and utilization for all patients who had at least one ED encounter with one or more diagnostic tests performed between October 1, 2016 and October 1, 2017. The total dataset for laboratory testing included 208,635 laboratory tests on 25,361 unique patients, of which 9,482 (37.4%) had active portal accounts. The total dataset for radiologic imaging included 23,504 radiology studies on 14,455 unique patients, of which 5,439 (37.6%) had an active portal account.

Results:

Overall, 8.9% (18,573/208,635) of laboratory tests and 9.0% (2,019/22,504) of radiology reports ordered in the ED were viewed in the patient portal. Highest rates of viewing of laboratory and radiology results were seen for females, 0-11 years (parent/guardian viewing by proxy), 18-60 years, and patients who self-reported their race as Caucasian and Asian. Lowest rates were for teenagers, 81+ years, African-American/Black, and Hispanic/Latino. Infectious disease, urinalysis, and pregnancy testing comprised the highest viewed laboratory tests. Magnetic resonance imaging reports were viewed at higher rates than computed tomography or x-ray studies (P < 0.001). Approximately half of all diagnostic test results accessed by patients were reviewed within 72 hours of availability in the patient portal (laboratory results: 9,904/18,573, 53.3%; radiology reports: 971/2,099, 46.3%). On the other extreme, 19.9% (3,701/18,573) of laboratory results and 30.4% (639/2,099) of radiology reports were viewed more than 2 weeks after availability in the portal.

Conclusions:

The data highlight relatively low use of a patient portal by ED patients and existing disparities between patient groups. There can be wide lag time (months) between result/report availability and access by patients. Opportunities for improvement exist for both activation and more robust utilization of patient portals by ED patients.